Individual provider Active NPI

Clifton Douyon

  • Licensed Practical Nurse
  • Rosedale, NY
National Provider Identifier
1659656718
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
307105-1 Issued in NY
Practice address
25526 Memphis Ave
Rosedale, NY 11422-2552
Phone
(786) 280-9177
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 307105-1 NY Primary
Licensed Practical Nurse 164W00000X PN5188454 FL

Addresses

Primary practice location

25526 Memphis Ave
Rosedale, NY 11422-2552

Mailing address

25526 Memphis Ave
Rosedale, NY 11422-2552
Phone (786) 280-9177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN5188454FLMDLicensed Practical Nurse
307105-1NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1659656718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25526 MEMPHIS AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222552",
            "telephone_number": "786-280-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25526 MEMPHIS AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222552",
            "telephone_number": "786-280-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUYON",
        "first_name": "CLIFTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "307105-1",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5188454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.